Termination: 10 Tips When Ending Psychotherapy

The end of the psychotherapy relationship is a difficult phase of therapy. Perhaps the second most difficult one, next to actually making the decision to try out psychotherapy in the first place and pour your heart out to a complete stranger (albeit a professional).

Therapists call the end of therapy “termination,” which doesn’t help in the “let’s give this a warm, fuzzy-feeling name to make it sound as least scary as possible” department. In everyday society, we typically “terminate” bugs or contracts, not relationships. But that’s psychology for you, always promoting psychobabble when simply calling it “ending therapy” would’ve sufficed.

Ending any relationship for most of us is not something that comes easily, or is second nature. In fact, ending a relationship may be one of the most difficult things we do in our lives. Many people simply don’t know how to handle the feelings accompanying the loss, and so it can be a very trying and stressful time even under the best of circumstances.

Most psychotherapy relationships end mutually, however, which makes them a little bit easier to handle. But not much. No matter what reason the relationship may be ending — the natural end of a course of therapy for a specific mental disorder, you or your therapist moving, a change in insurance coverage — here are some tips to make the transition easier for you.

10 Tips When Ending Psychotherapy

1. Understand The Process.

While many therapists are good about explaining the termination process, some are not. Termination starts with a discussion about whether it might be a good time to end therapy. Although it’s usually begun by the therapist, sometimes clients will get the ball rolling too (especially if they feel like they’re no longer “getting anything” from therapy).

After the discussion, if both parties have agreed to end therapy, a date is chosen, usually many weeks out. In the sessions between the initial decision and the chosen end date, the therapist spends time discussing how the client is feeling about the end of psychotherapy. Goals of therapy are discussed, and the progress made on those goals. The therapist will also often review the techniques learned in therapy, and strategies to ensure the client can rely on those techniques and tools in the future without the therapist’s help. A final session ends the process.

2. Bring It Up Early.

Most experienced psychotherapists are trained to start the termination process early — far earlier than most clients are probably used to or even comfortable with. Some therapists may start talking about it as far out as 10 or 12 sessions from the end (especially for longer-term therapy). This is a good thing. It gives you time to get comfortable with the idea, and it gives your mind time to get anxious — anxiety that can then be dealt with in your continuing psychotherapy sessions.

3. Pick A Final Session Date.

This is connected to bringing it up early: Your therapist should work with you on picking the date of your last session. It’s best to choose this date together, to ensure it’s not too early (for you) or that it doesn’t interfere with some other commitment either one of you may not know about. Such a date also acts as a mutual goal the both of you will work toward in your remaining sessions.

4. Let It Out.

Ending a psychotherapy relationship is just as difficult as ending any relationship in your life. That means you’re likely going to experience mixed emotions about the end of your relationship with your therapist. That’s fine, but it’s even better if you find a way to express those feelings to your therapist. Sometimes the end of therapy brings up a new issue that hasn’t yet emerged in session. This gives you time to work on these things — if work is needed — while there’s still time.

5. Anger And Anxiety Are Normal.

It’s perfectly normal to feel anger, anxiety, or a host of other emotions after your therapist has suggested it might be time to end the relationship. Express them. Write them out. Twitter them, or post them on your Facebook page. Whatever works for you, find a way to share these things with your therapist (and if not your therapist, some other outlet that gives you a sense of relief).

6. Ask Questions If You Have Them.

Sometimes the end of therapy brings up questions about the future. What if I relapse? Who do I call? Can I start therapy with you in the future if the need arises? Any books or support groups you recommend to help me with everyday coping? Can you give me a referral to another psychotherapist you recommend? Sometimes we get flustered or feel embarrassed to ask such questions at the end of therapy. Try to find a way to ask any questions you might have, since this may be the last chance you have to have a mental health professional’s opinion or help with them.

7. Knowing If You’re Not Ready.

Some people may not be ready to end therapy. You should talk to your therapist sooner rather than later if this is the case for you. You also have to try to separate out the feelings of “I’m not ready to do this” vs. “This is making me very anxious, but it feels like it’s the right time.” Just because talking about ending the relationship makes you feel anxious or uncomfortable doesn’t mean it isn’t right. But if you’re not ready to end it — because, for instance, you believe you have more work to do or more to learn — say so. Most therapists will respect your sense of whether it’s “right” or not and continue working with you.

8. It’s Done Face-To-Face.

The final session, as with most psychotherapy, is done face-to-face. Although some clients end up canceling their last session (with the sentiment of, “Why bother? We’re done, so let’s be done with it already”), it’s best to stick with it and attend the last session even if you don’t feel like it. Like ending any (hopefully!) positive relationship, it’s usually best to have one last final goodbye. It helps with “closure,” as therapists like to say.

9. The Final Session.

There is no “normal” way a final session goes — each therapist has his or her own way of doing it. It may involve a sort of encapsulating the months (or years) of therapy spent together, and ensuring the client is ready to move on in his or her life. Especially long-term or close therapeutic relationships may end with tears and a hug (if both parties agree). Shorter-term, solution-focused therapy will often end more business-like, with a handshake and best wishes.

10. Termination Is Not The End.

Although the word suggests an ending, termination really is the start of a new beginning for you. You are once again on your own in the world without the comfortable and safe weekly check-in with your therapist. And while that initially may be a little scary or sad, it marks another stage or transition in your life that you can embrace if you choose.

As the old saying goes, all good things must come to an end, and that includes psychotherapy too. Rest assured, however, that if you need to return to therapy in the future, a good therapist will be waiting for you.

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John M. Grohol, Psy.D.

Dr. John Grohol is the founder and Editor-in-Chief of Psych Central. He is an author, researcher, and expert in mental health online, and has been writing about online behavior, mental health and psychology issues since 1995. Dr. Grohol has a Master's degree and doctorate in clinical psychology from Nova Southeastern University. Dr. Grohol sits on the editorial board of the journal Computers in Human Behavior and is a founding board member of the Society for Participatory Medicine. You can learn more about Dr. John Grohol here.